Efficacy of quantified home-based exercise and supervised exercise in patients with intermittent claudication: A randomized controlled trial

Andrew W. Gardner, Donald E. Parker, Polly S. Montgomery, Kristy J. Scott, Steve M. Blevins

Research output: Contribution to journalArticle

152 Citations (Scopus)

Abstract

Background-This prospective, randomized, controlled clinical trial compared changes in exercise performance and daily ambulatory activity in peripheral artery disease patients with intermittent claudication after a home-based exercise program, a supervised exercise program, and usual-care control. Methods and Results-Of the 119 patients randomized, 29 completed home-based exercise, 33 completed supervised exercise, and 30 completed usual-care control. Both exercise programs consisted of intermittent walking to nearly maximal claudication pain for 12 weeks. Patients wore a step activity monitor during each exercise session. Primary outcome measures included claudication onset time and peak walking time obtained from a treadmill exercise test; secondary outcome measures included daily ambulatory cadences measured during a 7-day monitoring period. Adherence to home-based and supervised exercise was similar (P=0.712) and exceeded 80%. Both exercise programs increased claudication onset time (P<0.001) and peak walking time (P<0.01), whereas only home-based exercise increased daily average cadence (P<0.01). No changes were seen in the control group (P>0.05). The changes in claudication onset time and peak walking time were similar between the 2 exercise groups (P>0.05), whereas the change in daily average cadence was greater with home-based exercise (P<0.05). Conclusions-A home-based exercise program, quantified with a step activity monitor, has high adherence and is efficacious in improving claudication measures similar to a standard supervised exercise program. Furthermore, home-based exercise appears more efficacious in increasing daily ambulatory activity in the community setting than supervised exercise.

Original languageEnglish (US)
Pages (from-to)491-498
Number of pages8
JournalCirculation
Volume123
Issue number5
DOIs
StatePublished - Feb 8 2011

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Intermittent Claudication
Randomized Controlled Trials
Exercise
Walking
Exercise Test
Outcome Assessment (Health Care)
Peripheral Arterial Disease

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Gardner, Andrew W. ; Parker, Donald E. ; Montgomery, Polly S. ; Scott, Kristy J. ; Blevins, Steve M. / Efficacy of quantified home-based exercise and supervised exercise in patients with intermittent claudication : A randomized controlled trial. In: Circulation. 2011 ; Vol. 123, No. 5. pp. 491-498.
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Efficacy of quantified home-based exercise and supervised exercise in patients with intermittent claudication : A randomized controlled trial. / Gardner, Andrew W.; Parker, Donald E.; Montgomery, Polly S.; Scott, Kristy J.; Blevins, Steve M.

In: Circulation, Vol. 123, No. 5, 08.02.2011, p. 491-498.

Research output: Contribution to journalArticle

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T1 - Efficacy of quantified home-based exercise and supervised exercise in patients with intermittent claudication

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AU - Gardner, Andrew W.

AU - Parker, Donald E.

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AU - Scott, Kristy J.

AU - Blevins, Steve M.

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N2 - Background-This prospective, randomized, controlled clinical trial compared changes in exercise performance and daily ambulatory activity in peripheral artery disease patients with intermittent claudication after a home-based exercise program, a supervised exercise program, and usual-care control. Methods and Results-Of the 119 patients randomized, 29 completed home-based exercise, 33 completed supervised exercise, and 30 completed usual-care control. Both exercise programs consisted of intermittent walking to nearly maximal claudication pain for 12 weeks. Patients wore a step activity monitor during each exercise session. Primary outcome measures included claudication onset time and peak walking time obtained from a treadmill exercise test; secondary outcome measures included daily ambulatory cadences measured during a 7-day monitoring period. Adherence to home-based and supervised exercise was similar (P=0.712) and exceeded 80%. Both exercise programs increased claudication onset time (P<0.001) and peak walking time (P<0.01), whereas only home-based exercise increased daily average cadence (P<0.01). No changes were seen in the control group (P>0.05). The changes in claudication onset time and peak walking time were similar between the 2 exercise groups (P>0.05), whereas the change in daily average cadence was greater with home-based exercise (P<0.05). Conclusions-A home-based exercise program, quantified with a step activity monitor, has high adherence and is efficacious in improving claudication measures similar to a standard supervised exercise program. Furthermore, home-based exercise appears more efficacious in increasing daily ambulatory activity in the community setting than supervised exercise.

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